Your Classmates' Psych NP Clinical Experiences May Be Very Different From Yours
One thing I wish someone had told me before PMHNP clinicals is that your experience may look completely different from the experience of the person sitting next to you in class.
One student might spend most of clinical seeing adults with depression and anxiety. Another might be working primarily with children and adolescents.
Someone else might be in an inpatient setting seeing patients with severe mental illness, while another student is doing outpatient medication management.
One person may get to observe TMS or ketamine treatments. Another may never see either during their entire clinical rotation.
One student may have an incredibly involved preceptor who lets them conduct most of the interview and talk through every treatment decision. Another may spend much of their rotation observing.
And then there's always the student who seems to have seen every diagnosis, medication, and clinical scenario imaginable.
It's very easy to hear about someone else's clinical experience and think:
"Am I getting enough experience as a future PMHNP?"
Or worse:
"I'm behind."
Clinical Exposure Isn't Going to Be Identical
Your Psych NP clinical education isn't going to be perfectly standardized.
Even if you're in the same program, your clinical experiences can vary significantly based on:
Your clinical site
Your preceptor
The patient population
The setting
The number of patients seen
The diagnoses you encounter
The types of treatments offered
The opportunities your preceptor gives you
And, honestly, the patients who happen to walk through the door while you're there
You can't control all of those variables.
What you can control is how much you learn from the experience you're given as PMHNP student.
Don't Turn Someone Else's Experience Into Your Deficit
This can be particularly difficult when you're talking with fellow Psych NP students.
Someone might say:
"I've already seen three patients with bipolar disorder this week."
And suddenly you're wondering if you should be concerned because you haven't.
Or:
"My preceptor lets me prescribe everything."
And you start questioning whether your preceptor isn't giving you enough responsibility.
Or:
"I've already seen patients with schizophrenia, ADHD, PTSD, borderline personality disorder, and substance use disorders."
Meanwhile, you've spent the last two weeks seeing mostly depression and anxiety.
That doesn't necessarily mean you're getting a worse clinical education.
It means you're having a different PMHNP clinical experience.
There are certainly situations where a clinical placement isn't providing adequate learning opportunities, and those concerns should be addressed with your program. But don't assume that every difference between your experience and someone else's means you're falling behind.
Use Your Classmates' Experiences as a Learning Opportunity
Instead of comparing yourself to your classmates, get curious about what they're seeing.
If someone tells you they encountered a diagnosis you haven't seen yet, ask:
"What did that presentation look like?"
Or:
"What did your preceptor do?"
Or:
"What did you find challenging about that patient?"
You can learn from experiences that aren't technically yours. Your classmates can expose you to clinical situations you may not encounter during your own rotation. And you can do the same for them.
Keep Track of Your Own Gaps
At the same time, knowing that everyone's experience is different doesn't mean you should ignore areas where you need more exposure.
If you realize you've had very little experience with:
Pediatric patients
Older adults
Psychosis
Bipolar disorder
Substance use
Personality disorders
ADHD
Inpatient psychiatry
Certain medications or treatment modalities
make a note of it.
You may not be able to change your clinical placement, but you can use those gaps to guide your studying.
You can also talk to your preceptor about them.
For example:
"I haven't had much exposure to patients with bipolar disorder yet. If we have an appropriate patient today, would you mind letting me take the lead on the assessment?"
That's much more productive than simply worrying that you're behind.
Your Clinical Experience Is One Piece of Your Education
It's important to remember that clinical is only one part of your education.
You aren't expected to encounter every diagnosis, medication, patient population, and clinical situation before graduation.
There will be things you don't see during clinical. There will be medications you never prescribe as a student. There will be diagnoses you only read about. And there will be situations you encounter for the first time after graduation.
That's normal.
Your goal isn't to graduate having seen everything. Your goal is to graduate knowing how to approach something you've never seen before. That's a much more valuable skill.
One of the Best Things You Can Do
Instead of asking:
"Am I seeing enough?"
try asking:
"Am I learning from what I'm seeing?"
Are you becoming better at conducting psychiatric interviews?
Are you getting better at identifying relevant symptoms?
Are you beginning to recognize patterns?
Are you developing differentials?
Are you understanding why your preceptor makes certain treatment decisions?
Are you becoming more comfortable presenting patients?
Are you identifying the things you don't know and looking them up?
If the answer is yes, you're making progress. Your clinical experience doesn't have to look like everyone else's to be valuable.
